2026-04-17T11:31:50Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/129392025-10-24T10:31:17Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:31:17Z urn:hdl:11351/12939 Cardiac Tamponade Complicating Type A Acute Aortic Dissection: Insights From 25 Years of Registry Research Gilon, Dan Korach, Amit carbone, andreina Brinster, Derek R. Estrera, Anthony Evangelista Masip, Arturo Cor - Malalties - Complicacions Aorta - Dissecció Cor - Cirurgia DISEASES::Cardiovascular Diseases::Heart Diseases::Cardiac Tamponade Other subheadings::Other subheadings::Other subheadings::/complications DISEASES::Cardiovascular Diseases::Vascular Diseases::Aneurysm::Aneurysm, Dissecting DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Thoracic Surgery ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::taponamiento cardíaco Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::aneurisma::aneurisma disecante DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía torácica Malaltia aòrtica; Tamponament cardíac; Dissecció aòrtica aguda tipus a Enfermedad aórtica; Taponamiento cardíaco; Disección aórtica aguda tipo a Aortic disease; Cardiac tamponade; Type a acute aortic dissection Background Cardiac tamponade (TMP) is a catastrophic complication of type A acute aortic dissection (TAAAD), increasing the risk of morbidity and mortality. Objectives The present study aimed to assess the characteristics, management, and outcomes of TAAAD patients with preoperative TMP enrolled in the International Registry of Acute Aortic Dissection database from 1996 to 2022. Methods Data from 63 aortic centers were analyzed and TAAAD patients with and without preoperative TMP were compared. Multivariable modeling to assess factors associated with the presence of preoperative cardiac TMP and survival curves were performed. Overall median follow-up was 35.8 months (Q1-Q3: 11.6-59.4 months). Results Of the 6,014 patients with TAAAD in the International Registry of Acute Aortic Dissection during the 25-year study period, 865 individuals (14.4%) developed TMP. Patients with TMP were older (age 64.9 vs 60.8 years; P < 0.0001) and less often male (61.8% vs 66.8%; P = 0.005). No differences were seen in time to presentation or diagnosis. Prior cardiac surgery was less common in patients with TMP (7.6% vs 12.8%; P < 0.0001). Syncope (37.4% vs 13.4%; P < 0.0001) and coma or altered consciousness (28% vs 8%; P < 0.0001) on presentation were more frequent in the TMP group. The majority of the cohort were managed surgically, rates of which were similar between groups (87.5% vs 87.7%; P = 0.911). In-hospital mortality was higher in patients with TMP (38.4% vs 15.4%; P < 0.001) but 4-year survival was similar (log-rank P = 0.767). Conclusions TMP is an important prognosticator of in-hospital mortality. It is associated with increased mortality of TAAAD and prompt surgery is required. Those who survive the hospital course, go on to share the same postdischarge course as those who did not have TMP. 2025-10-24T10:31:17Z 2025-10-24T10:31:17Z 2025-04-11T07:07:10Z 2025-04-11T07:07:10Z 2025-04 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/12939 JACC: Advances;4(4) https://doi.org/10.1016/j.jacadv.2025.101632 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia